Biochemical criteria for pulmonary surfactant damage in tuberculosis patients with previous work in dusty conditions

Abstract

Introduction. Among the mechanisms of pathogenesis of tuberculosis is damage to the pulmonary surfactant. In patients with tuberculosis who previously worked in an industrial dusty environment, the pulmonary surfactant system is affected by two damaging factors simultaneously.The aim of the work was to determine the role of biochemical criteria of pulmonary surfactant damage as early molecular markers of the sub-radiological stage of pneumoconiosis in pulmonary tuberculosis patients.Materials and methods. The object of the study was 91 patients with pulmonary tuberculosis, of whom 59 patients had contact with industrial quartz-containing dust in the course of their work (the main group) and 32 patients − with an unburdened professional route (the control group). The content of total protein (TP), total phospholipids (TPL), phospholipid spectrum by thin-layer chromatography as criteria of pulmonary surfactant damage were studied biochemically in bronchoalveolar flushes (BAF).Results. It was found that in bronchoalveolar flushes of patients with tuberculosis of dust-hazardous professions, in group 1, the content of total protein increases, while the level of total phospholipids does not statistically significantly change in comparison with patients with an unburdened professional route. Among the phospholipids of BAF, phosphatidylcholine (PC), phosphatidiylethanolamine (PEA) and cardiolipin (CL) are the most common. In the BAF of the 1st group of patients, a frequent combination of fractions of PC and CL was found, in the 2nd group − PC, PEA and CL. Combinations containing sphingomyelin (SPM), PC and CL were found only in groups 1 and 2. It was also found that the level of total protein in BAF varies depending on the activity of the process, so in patients of group 1 with the presence of areas of destruction of lung tissue, the content of total protein significantly exceeded that in patients with specific inflammation subsiding.Discussion. Patients with pulmonary tuberculosis with dust exposure develop sub-radiological manifestations of pneumoconiosis in the form of impaired metabolism and biochemical composition of pulmonary surfactant, which is caused both by the dust factor and the influence of specific inflammation.Conclusion The role of biochemical criteria of pulmonary surfactant damage as early molecular markers of the sub-radiological stage of pneumoconiosis in pulmonary tuberculosis patients was determined.